Hepatic Artery Resistance Index as a Prognostic Marker in Liver Cirrhosis: A Case-Control Study

Introduction: Liver cirrhosis poses significant prognostic challenges, necessitating non-invasive tools like the hepatic artery resistance index (HARI) to assess disease severity. This study evaluated HARI’s prognostic utility among cirrhotic patients in Iran. Methods: In a case–control study conducted at Afzalipour Hospital in Kerman, Iran, in 2021, 25 patients with liver cirrhosis and 25 healthy controls were enrolled. We measured HARI, pulsatility index (PI), and peak systolic velocity (PSV) by Doppler ultrasound. Laboratory parameters (albumin, creatinine, INR, prothrombin time) and prognostic scores (Child-Pugh, MELD) were assessed. Data were analyzed using t-tests, ANOVA, and Pearson’s correlations in SPSS version 25 (P < 0.05). Results: Cirrhotic patients exhibited significantly higher HARI (0.81 ± 0.10 vs. 0.44 ± 0.10, P < 0.001), PI (1.23 ± 0.20 vs. 1.03 ± 0.11, P < 0.001), and PSV (102.16 ± 2.54 vs. 73.88 ± 5.80 cm/s, P < 0.001) than controls. HARI increased across Child-Pugh classes (A: 0.76 ± 0.04, B: 0.81 ± 0.14, C: 0.91 ± 0.02, P = 0.002) and correlated moderately with MELD (r = 0.52, P = 0.008) and Child-Pugh scores (r = 0.48, P = 0.015). Albumin was lower (1.44 ± 0.49 vs. 3.56 ± 1.36 g/L, P = 0.002) and creatinine was higher (1.97 ± 0.97 vs. 1.24 ± 0.27 mg/dL, P = 0.013) in cases. Conclusion: HARI is a promising non-invasive marker for cirrhosis prognosis, particularly in severe cases. Larger studies are needed to establish standardized thresholds.